| NPI | 1083879506 |
|---|---|
| Other Name | MARY LOUISE MACILVAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 14409) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: CA 14409) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |