| NPI | 1588877146 |
|---|---|
| Former Name | SUZANNE CHRISTINE DEVYLDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401011616) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101006447) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-08-03 |