| NPI | 1316204803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L8082) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC6852) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 19-R-12) | |
| 1041C0700X Social Worker, Clinical (Licence: ME LC15259) | |
| Enumeration Date | 2012-04-20 | 
| Last Update Date | 2019-05-08 |