| NPI | 1114414562 |
|---|---|
| Former Name | MELISSA MASTERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 023897) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY P101791) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2020-09-23 |