NPI | 1972175768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 38943) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 38943) |
Enumeration Date | 2021-07-12 |
Last Update Date | 2021-09-21 |