NPI | 1467731356 |
---|---|
Former Name | MELISSA DAWN WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY29758) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103T00000X Psychologist | |
Enumeration Date | 2011-08-09 |
Last Update Date | 2023-08-09 |