| NPI | 1154468130 |
|---|---|
| Former Name | JENNI E. STAFFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC12418) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC4311) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2016-06-22 |