| NPI | 1225780380 |
|---|---|
| Former Name | BAILEY MICHELLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 07657-C) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2024-09-03 |