| NPI | 1205897386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME LC10195) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME CCS5310) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC3839) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-07-17 |