| NPI | 1780738617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY2057) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CO 2057) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-09-28 |