NPI | 1720286982 |
---|---|
Former Name | NICOLE M BISAILLON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 068.0087757) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 005155-1) |
101YM0800X Counselor, Mental Health (Licence: VT 068.0087757) | |
Enumeration Date | 2007-07-10 |
Last Update Date | 2023-11-16 |