| NPI | 1114087194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME AD3124) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME LS9754) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |