| NPI | 1790039063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OR 3053) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WA PY 60296079) |
| 103T00000X Psychologist (Licence: OR 3053) | |
| 103T00000X Psychologist (Licence: MI 6301014490) | |
| 103TC0700X Psychologist, Clinical (Licence: OR 3053) | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2022-10-18 |