NPI | 1730377961 |
---|---|
Former Name | MELISSA RUTH STEVENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007335) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015296) |
Enumeration Date | 2007-10-12 |
Last Update Date | 2015-01-27 |