| NPI | 1619152162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC2299) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC3618) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2010-10-06 |