| NPI | 1861565210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 1514) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 1514) |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0200X Psychologist Forensic | |
| 103TH0004X Psychologist Health | |
| 103TH0100X Psychologist Health Service | |
| 103TR0400X Psychologist Rehabilitation | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2022-07-21 |