| NPI | 1063176766 |
|---|---|
| Former Name | MICHELLE KOSTSZEWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY P104571-01) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2025-01-03 |