| NPI | 1306370481 |
|---|---|
| Former Name | MICHELLE LEE SVRCEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 18532) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |