NPI | 1164801288 |
---|---|
Former Name | MICHELLE BRITTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180011143) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178010997) |
Enumeration Date | 2015-05-21 |
Last Update Date | 2024-05-28 |