| NPI | 1780095661 |
|---|---|
| Former Name | MEGAN MARIE FORTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC4952) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2019-02-21 |