| NPI | 1144413477 |
|---|---|
| Former Name | MELISSA FAY BUBAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY23451) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY23451) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA PSY23451) | |
| 103TF0000X Psychologist Family (Licence: CA PSY23451) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2010-06-24 |