NPI | 1073833067 |
---|---|
Former Name | MELISSA ANN KRUEGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2021-02902) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 288117-1) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 268117) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA MD460037) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 61409) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MO 2021035786) | |
Enumeration Date | 2010-06-02 |
Last Update Date | 2023-08-21 |