| NPI | 1801493168 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC13758) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC5821) | 
| Enumeration Date | 2020-10-08 | 
| Last Update Date | 2024-02-23 |