NPI | 1609176643 |
---|---|
Former Name | MELANIE CRUMBIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 2996) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CT 2995) |
Enumeration Date | 2010-10-25 |
Last Update Date | 2013-11-11 |