| NPI | 1972841542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36175) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 36175) |
| 103T00000X Psychologist (Licence: TX 36175) | |
| 103TH0004X Psychologist, Health (Licence: TX 36175) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: TX 36175) | |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |