| NPI | 1538218151 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: ME CC 1189)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC 644)  | 
| Enumeration Date | 2007-01-10 | 
| Last Update Date | 2025-09-11 |