| NPI | 1700281706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME LC23442) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC7567) |
| 1041C0700X Social Worker Clinical (Licence: VT 156.0133973TELE) | |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2024-05-01 |