| NPI | 1588932776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 63157) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC14189) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5547) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2016-12-15 |