| NPI | 1386213478 |
|---|---|
| Former Name | MELISSA ANN FETTERER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2021021974) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-06-22 |