| NPI | 1952706434 |
|---|---|
| Former Name | MACKENZIE L. MICHAEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 4188) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2019-05-20 |