| NPI | 1649717380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC5236) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME XL4798) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5228) | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2019-12-15 |