| NPI | 1073005039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1139) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC24169) |
| 1041C0700X Social Worker, Clinical (Licence: NH 2413) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-10-30 |