| NPI | 1255421160 |
|---|---|
| Former Name | MICHELLE GROVE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C3654) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401007719) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-03-03 |