| NPI | 1649324922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC3504) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC4515) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2010-01-09 |