| NPI | 1780613596 |
|---|---|
| Former Name | MELISSA KAYE HAGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN 4582) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN 4582) |
| 103TC0700X Psychologist Clinical (Licence: MN LP4582) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-04-13 |