| NPI | 1417324518 |
|---|---|
| Former Name | MELISSA K. COUSINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301016240) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016240) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2020-11-11 |