| NPI | 1861615593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC4379) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME LC 4379) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2016-07-12 |