| NPI | 1154824761 |
|---|---|
| Former Name | LISA MICHELE TALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2018-06-01 |