| 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 |