| NPI | 1780934844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC4557) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME cac4557) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |