| NPI | 1770644809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY6594) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY6594) |
| 103TF0200X Psychologist, Forensic (Licence: FL PY6594) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-02-26 |