NPI | 1902105497 |
---|---|
Former Name | ANNA L GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC4072) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC5248) |
101YP2500X Counselor, Professional (Licence: ME XL3770) | |
Enumeration Date | 2011-03-23 |
Last Update Date | 2022-09-14 |