| NPI | 1770632010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: GA 003053) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: GA 003053) |
| 103TC0700X Psychologist, Clinical (Licence: GA 003053) | |
| 103T00000X Psychologist (Licence: GA 003053) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |