| NPI | 1750865739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME LC19444) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC7015) |
| 101YM0800X Counselor, Mental Health (Licence: MA 123730) | |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2021-10-13 |