| NPI | 1093108490 |
|---|---|
| Former Name | MICHELLE DIANNE SEPULVEDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC014672) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: PA PC014672) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2022-08-24 |