NPI | 1417438789 |
---|---|
Former Name | MICHELLE MARIE KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C014345) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801103160) |
1041C0700X Social Worker, Clinical (Licence: NC PO13055) | |
Enumeration Date | 2018-08-24 |
Last Update Date | 2023-11-08 |