| NPI | 1861161598 |
|---|---|
| Former Name | MICHELLE R SLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 2421) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-10-27 |