| 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 |