| NPI | 1659653632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC4294) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC4610) |
| 101YP2500X Counselor, Professional (Licence: ME XL3869) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2016-07-13 |