| NPI | 1003599762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: T-24-3639) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 22-CRM-1469) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2025-05-13 |