| NPI | 1114376142 |
|---|---|
| Former Name | MEGAN ELIZABETH BAILLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT Bbh-lcpc-lic-17898) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-50745) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2023-07-10 |