| NPI | 1821140633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: SC 729)  | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC SC729)  | 
| 103T00000X Psychologist (Licence: SC 729)  | |
| 103TC0700X Psychologist, Clinical (Licence: SC 729)  | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: SC 729)  | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 729)  | |
| 103TH0100X Psychologist, Health Service (Licence: SC 729)  | |
| 103TR0400X Psychologist, Rehabilitation (Licence: SC 729)  | |
| Enumeration Date | 2007-01-18 | 
| Last Update Date | 2021-05-11 |