| NPI | 1558739482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC4752) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME cac6372) |
| 101YP2500X Counselor, Professional (Licence: TX 71662) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2019-04-23 |