NPI | 1407511421 |
---|---|
Former Name | JUSTINE MICHAEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 4290) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 10941-125) |
Enumeration Date | 2021-11-04 |
Last Update Date | 2024-05-03 |