| NPI | 1609187855 |
|---|---|
| Former Name | SHELLEY MB WIEGAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401006918) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802080124) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |