| NPI | 1760786255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 707) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 707) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 707) | |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2012-06-14 |