NPI | 1760500276 |
---|---|
Former Name | MICHELLE ANGELA DYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 003272-1) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1-11-8757) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2012-03-01 |