| NPI | 1982079588 |
|---|---|
| Former Name | MARSHA LYNNE DALLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI L869068) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MI SC0000459) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2024-08-16 |