| NPI | 1962786970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: ME LC13032) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 119801) | 
| 101Y00000X Counselor | |
| Enumeration Date | 2011-10-10 | 
| Last Update Date | 2021-02-21 |