| NPI | 1063836732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC20073)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC8912)  | |
| Enumeration Date | 2014-02-14 | 
| Last Update Date | 2025-01-27 |