| NPI | 1255931697 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC21139) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CCS8543) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC8009) | |
| 1041C0700X Social Worker, Clinical (Licence: MA LICSW126257) | |
| Enumeration Date | 2020-10-26 | 
| Last Update Date | 2023-11-16 |