| NPI | 1356813166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ME CC5980) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC7446) |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2023-02-01 |