| NPI | 1821346495 |
|---|---|
| Former Name | STACEY RESNICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KS 04-38502) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2016-02-02 |