| NPI | 1528350295 |
|---|---|
| Former Name | SHELLY MARIE HOULE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 0680057754) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000482) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |