| NPI | 1518369370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME LC14380) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME LC14380) |
| 101YM0800X Counselor Mental Health (Licence: ME LC14380) | |
| 101YP2500X Counselor Professional (Licence: ME LC14380) | |
| 104100000X Social Worker (Licence: ME LC14380) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC14380) | |
| 1041S0200X Social Worker School (Licence: ME LC14380) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2016-08-25 |