| NPI | 1780168765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3600) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 3600-57) |
| 103T00000X Psychologist (Licence: WI 3600-57) | |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2021-09-28 |