| NPI | 1427177484 |
|---|---|
| Former Name | MELBA JENINE NICHOLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 018720) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY 22925) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071006957) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2019-03-13 |