| NPI | 1043384696 |
|---|---|
| Former Name | MICHELLE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 113144) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 11828-C) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-04-06 |