| NPI | 1245938521 |
|---|---|
| Former Name | MARIAH LYN DUFOUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME MC20224) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC8169) |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-02-16 |