| NPI | 1639330285 |
|---|---|
| Former Name | MARY ELLEN RAE BERTLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401007799) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NV CP1132) |
| 101Y00000X Counselor (Licence: MI 6401007799) | |
| 101YP2500X Counselor, Professional (Licence: NV CP1132) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-02-03 |