| NPI | 1073057865 |
|---|---|
| Former Name | MICHELLE JEANETTE SCULLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60904652) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA SC60443410) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2022-09-28 |