| NPI | 1134273030 |
|---|---|
| Former Name | MICHELLE ROANN MUNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 3023) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 656) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-10-27 |