| NPI | 1063915304 |
|---|---|
| Former Name | LEANN NICOLE BASTIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401224764) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401016474) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2025-01-21 |