| NPI | 1689647521 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC10502) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME MC7731) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-07-02 |