NPI | 1275736902 |
---|---|
Former Name | MELANIE JEANNINE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 68037) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 68037) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2012-01382) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-17357) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2012-01382) | |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-17357) | |
Enumeration Date | 2007-06-08 |
Last Update Date | 2020-08-20 |