NPI | 1063651396 |
---|---|
Former Name | MELISSA ROSE TROVATO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA A109700) |
Enumeration Date | 2009-02-10 |
Last Update Date | 2018-02-22 |