| NPI | 1417482449 |
|---|---|
| Former Name | ELISE MICHELLE STEPHENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 62235) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2025-03-17 |