| NPI | 1215418330 |
|---|---|
| Former Name | MICHELLE ANN BEAURLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 1909) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303627) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |