| NPI | 1194200519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME MC18090) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC6584) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2020-05-27 |