Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY18187 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY18187 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY18187 | CA |
NPI | 1104118280 |
---|---|
Provider Name | Dr. Melissa Brymer |
First Address | Torrance, CA 90504-3637 |
Second Address | Beverly Hills, CA 90212-2928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2011 |
Last Update Date | 09/05/2011 |