| NPI | 1073847299 |
|---|---|
| Former Name | NICOLA J CANNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC4564) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME XL4368) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2015-08-31 |