| NPI | 1376968495 |
|---|---|
| Former Name | MICHELLE RENEE MCCLELLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-053076) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2022-12-04 |