| NPI | 1821492372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 37109) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY 9069) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY 9069) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 9069) | |
| 103TH0004X Psychologist, Health (Licence: FL PY 9069) | |
| 103TC0700X Psychologist, Clinical (Licence: TX 37109) | |
| 103TH0004X Psychologist, Health (Licence: TX 37109) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 37109) | |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2015-12-17 |