NPI | 1154830073 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0134405) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC6285) |
1041C0700X Social Worker, Clinical (Licence: ME LC17651) | |
Enumeration Date | 2017-09-22 |
Last Update Date | 2022-05-12 |