| NPI | 1417187402 |
|---|---|
| Former Name | ROXANNE MARIE MYSINGER / MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 21599) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 21599) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2018-07-18 |