| NPI | 1902974116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC8528) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC2384) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CCS2828) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2011-01-04 |