| NPI | 1033532031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ME XL3977) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC5153) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |