| NPI | 1619451754 |
|---|---|
| Former Name | MICHELLE VILLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 132236) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: CA 132236) |
| 103TC0700X Psychologist, Clinical (Licence: CA 132236) | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2024-02-07 |