| NPI | 1952443640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ID 120) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: ID 120) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: ID 120) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: ID 120) | |
| 103TR0400X Psychologist Rehabilitation (Licence: ID 120) | |
| 103TS0200X Psychologist School (Licence: ID 120) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2013-01-10 |