| NPI | 1730870205 |
|---|---|
| Former Name | SHELLEY SUZANNE NICHOLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61445805) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-08-18 |