| NPI | 1255854394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC6813) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME 101Y0000X) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2019-08-23 |