| NPI | 1760531966 |
|---|---|
| Other Name | MICKI MARILYN KLOSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ LMFT0157) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: AZ 2948116) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |