| NPI | 1134787617 |
|---|---|
| Former Name | MICHELLE LEE GWALTNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C016092) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC P013454) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2023-11-28 |