| NPI | 1750905295 |
|---|---|
| Former Name | THERESA MCGINNIS MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401224368) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-04-10 |