| NPI | 1629218847 |
|---|---|
| Former Name | MICHELLE MARIE GAUDREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC4207) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6905) |
| 101YS0200X Counselor, School (Licence: MA 6905) | |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2023-06-01 |