NPI | 1811151582 |
---|---|
Former Name | MISTI MICHELLE TUERCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36270) |
Enumeration Date | 2008-07-11 |
Last Update Date | 2013-05-09 |