| NPI | 1770732778 |
|---|---|
| Other Name | MICHELLE DEFORREST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC004780) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2009-02-18 |