| NPI | 1003117573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ME XL3593) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC4852) | |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2012-05-31 |