| NPI | 1801216452 |
|---|---|
| Former Name | MEREDITH SOURK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2023036668) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KS 03162) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2025-12-18 |