| NPI | 1063426104 |
|---|---|
| Former Name | MARIELLEN E NORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 02149) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MD 02149) |
| 103TC0700X Psychologist, Clinical (Licence: MD 02149) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 02149) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-09 |