| NPI | 1790851582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OR 1487) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OR L2780) |
| Enumeration Date | 2006-11-26 |
| Last Update Date | 2007-07-08 |