| NPI | 1013116342 |
|---|---|
| Former Name | MICHELLE PEMBLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MN LP4824) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4824) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2023-09-13 |