| NPI | 1154897585 |
|---|---|
| Former Name | STEPHANIE N WITHEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC19931) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME MC17672) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2022-12-28 |