| NPI | 1396379939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC5267) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC6931) |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2020-03-30 |