| NPI | 1548728629 |
|---|---|
| Former Name | MICHELLE MARIE EYL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1848) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-09-16 |