| NPI | 1760731707 |
|---|---|
| Former Name | JANE ANN TULL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME MC13689) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5226) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |