| NPI | 1548601487 |
|---|---|
| Former Name | OLIVIA MARIE CLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401014927) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014927) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C03439) | |
| 101YM0800X Counselor Mental Health (Licence: MI 6401014927) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2019-10-15 |