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 |