| NPI | 1013515238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: TX 50025-0820) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 172A00000X Driver | |
| 174H00000X Health Educator | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2022-01-04 |