| NPI | 1295979128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME XL3253) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC4040) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2011-03-14 |