| NPI | 1700033693 |
|---|---|
| Former Name | LINDA JEAN ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC3364) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CC53895) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2018-03-14 |