| NPI | 1669704938 |
|---|---|
| Former Name | ELLEN MICHELLE HADDOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 171784) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2022-01-26 |