NPI | 1578994976 |
---|---|
Former Name | MICHELLE A LEROY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3802) |
Additional Taxonomies | 103T00000X Psychologist |
103T00000X Psychologist (Licence: MN LP5782) | |
Enumeration Date | 2013-12-10 |
Last Update Date | 2024-01-30 |