NPI | 1407103989 |
---|---|
Former Name | MELISSA ALICE MARRION |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2015033047) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2012-08-14 |
Last Update Date | 2019-03-15 |