| NPI | 1861740854 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000788) | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: DC PSY1000788) | 
| 103TH0004X Psychologist, Health (Licence: DC PSY1000788) | |
| Enumeration Date | 2012-08-22 | 
| Last Update Date | 2014-02-14 |