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 |