| NPI | 1760594055 |
|---|---|
| Former Name | MICHELLE LILLIAN JANICKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 528823) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 225X00000X Occupational Therapist (Licence: MA 660646) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-08-03 |