| NPI | 1003592759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3997) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR THW000106791) |
| 175T00000X Peer Specialist (Licence: OR THW000106791) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 23-CRM-1675) | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2024-12-03 |