NPI | 1841613957 |
---|---|
Former Name | KELLY MESSING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401007561) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C-00017) |
101YS0200X Counselor School (Licence: MI SC0000169) | |
Enumeration Date | 2014-01-24 |
Last Update Date | 2014-01-24 |