| NPI | 1467749366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC5290) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CAC4877) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2015-12-14 |