| NPI | 1689478745 |
|---|---|
| Former Name | MELISSA OTILIA WOLFGRAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP7089) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-08-15 |