| NPI | 1043007701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WV 25-945sud) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2026-04-28 |