| NPI | 1003679598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 00241179224) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: FL 00-334-5259-229) |
| 374U00000X Home Health Aide (Licence: FL 01241179224) | |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-02-10 |