NPI | 1316117088 |
---|---|
Former Name | ANGELA MARIE FISH FLEISHANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013986) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013986) |
Enumeration Date | 2008-03-10 |
Last Update Date | 2024-02-03 |