| NPI | 1679648638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID 32114) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME 40) |
| 1041C0700X Social Worker, Clinical (Licence: ME 666) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2016-05-02 |