| NPI | 1013698612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM CTB-2023-0629) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NM 1311) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-11-19 |