NPI | 1841498201 |
---|---|
Former Name | MICHELLE YVONNE GANGITANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS25338) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 17134) |
Enumeration Date | 2007-07-06 |
Last Update Date | 2023-06-16 |