| NPI | 1356877567 |
|---|---|
| Former Name | MICHELLE KATHLEEN WIRTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 283X00000X Rehabilitation Hospital (Licence: IL 056011970) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2021-05-27 |