NPI | 1245573021 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC4848) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC6562) |
101YM0800X Counselor, Mental Health (Licence: ME XL4112) | |
Enumeration Date | 2013-03-31 |
Last Update Date | 2020-10-23 |