| NPI | 1366849978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC18224) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME MC15727) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME cac5568) | |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2019-11-20 |