| NPI | 1649269739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC13932) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC3232) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC4596) | |
| 1041C0700X Social Worker, Clinical (Licence: ME MC12423) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2013-03-08 |