| NPI | 1689878274 |
|---|---|
| Former Name | MELISSA KAY STANLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX N8391) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX BP1-0026583) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2011-04-15 |