| NPI | 1891778833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME #CC3239) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME #CAC4421) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2010-01-17 |