| NPI | 1336268804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 206039) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC2458) |
| 106H00000X Marriage & Family Therapist (Licence: MA 617) | |
| 101YM0800X Counselor, Mental Health (Licence: MA 1621) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-03-27 |