| NPI | 1144450966 |
|---|---|
| Former Name | VICTORIA MYLECRAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 28965) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2019-03-15 |