| NPI | 1043190846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA CG70040495) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG70040495) | 
| Enumeration Date | 2025-09-03 | 
| Last Update Date | 2025-09-03 |