| NPI | 1265623854 |
|---|---|
| Former Name | MIRA BRANCU GREENE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4061) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4061) |
| 284300000X Special Hospital (Licence: NC 4061) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2011-01-25 |