| NPI | 1609269711 |
|---|---|
| Former Name | KAYLA BOURGOIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC19264) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME MC17407) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2021-02-02 |