| NPI | 1962627539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC12287) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME MC10670) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2019-06-12 |