Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2011032576 | MO |
NPI | 1083921381 |
---|---|
Provider Name | Michaela Muehlbach |
First Address | Clinton, MO 64735-8804 |
Second Address | Rolla, MO 65401-3648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 24/01/2020 |