| NPI | 1922658913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC6989) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CCS7995) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2023-09-29 |