NPI | 1063699023 |
---|---|
Former Name | MERY JESSY MACALUSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY21828) |
Enumeration Date | 2008-01-22 |
Last Update Date | 2008-01-22 |