| NPI | 1033367925 |
|---|---|
| Former Name | MICHELE COLLEEN COPP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1251) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-04 |