| NPI | 1619354636 |
|---|---|
| Former Name | MELISSA A KNOWLTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60472709) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 4062) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |