| NPI | 1124458948 |
|---|---|
| Former Name | MACIE ANN BREACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60515883) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-5418) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2018-06-05 |