| NPI | 1730315011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ME CC4039) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME LC 2705) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2019-10-23 |