NPI | 1891118808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006149) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AR 14-04P) |
Enumeration Date | 2014-01-27 |
Last Update Date | 2020-06-22 |