| NPI | 1316307507 |
|---|---|
| Former Name | MICHELLE ELAINE RYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |