NPI | 1699067611 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC12953) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC4920) |
Enumeration Date | 2011-05-10 |
Last Update Date | 2011-05-10 |