| NPI | 1235204348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LC3437) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME CCS3670) |
| 1041C0700X Social Worker, Clinical (Licence: ME LC8123) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2021-12-10 |