NPI | 1578609715 |
---|---|
Former Name | MICHELLE DENISE LAVOIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 1398) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5688) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2020-12-07 |