| NPI | 1548990112 |
|---|---|
| Former Name | MARTHA FAHLGREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 11938) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 11938) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2026-07-09 |