| NPI | 1215962584 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC6213) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC2027) | 
| 101YM0800X Counselor, Mental Health (Licence: ME LC6213) | |
| Enumeration Date | 2006-07-12 | 
| Last Update Date | 2017-04-17 |