| NPI | 1891109617 |
|---|---|
| Former Name | MELODY BRENNEISEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-38841) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-LMFT-LIC-38685) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2019-08-26 |