| NPI | 1013606391 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: UT FPSS-01515) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: UT 1013606391) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-02-10 |