| NPI | 1164575155 |
|---|---|
| Former Name | AMANDA LEIGH MICHELICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 5421) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 5421) |
| 251S00000X Community/Behavioral Health (Licence: NC 5421) | |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2022-06-06 |