| NPI | 1760859490 |
|---|---|
| Former Name | MICHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8337) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 8337-123) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2021-06-29 |