| NPI | 1053960831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ME LC4391) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME CCS4550) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |