| NPI | 1083712947 |
|---|---|
| Former Name | MICHELLE MARIE KIERSTEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 10477) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LMSW 12058) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2019-02-12 |