NPI | 1316075104 |
---|---|
Other Name | PAMELA RUTH BURRIDGE ROSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MN LP0260) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 232) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2007-07-09 |