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 |