| NPI | 1780985960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ME LSX12762) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME XL4111) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5239) | |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2014-06-20 |