| NPI | 1306907811 |
|---|---|
| Former Name | MAGGIE FENNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ME MF4022) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T0398) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-01-04 |