Individual
MICHELLE DIANE HANNINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 CALAVERAS AVE, MODESTO, CA 95354-3621
(209) 550-5858
Mailing address
1292 PASEO BELLEZA, TURLOCK, CA 95382-7396
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
IMF 54366
CA
Other
Enumeration date
03/09/2007
Last updated
05/22/2009
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