NPI | 1699137349 |
---|---|
Former Name | MICHELLE LYNN NIEUWENHEIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5718) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 5718-125) |
Enumeration Date | 2016-03-22 |
Last Update Date | 2018-07-12 |