| NPI | 1376830752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC7394) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2021-05-04 |