| NPI | 1841624640 |
|---|---|
| Former Name | CALLIE J BROCKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 1355) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: LA 1355) | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2022-09-14 |