| NPI | 1417095910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC349) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ME CC1229) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |