| NPI | 1053678714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME MH605962) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME SA606205) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2012-04-19 |