| NPI | 1033836614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NV 06870-I) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NV 5060) |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |