| NPI | 1417019274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CADC CAC2971) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA LICSW 113669) |
| 1041C0700X Social Worker Clinical (Licence: ME LCSW LC7299) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |