| NPI | 1659315539 |
|---|---|
| Former Name | MEADOW MARIE ROUSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NE 651) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 2549) |
| 1041C0700X Social Worker, Clinical (Licence: NE 1065) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-03-30 |