| NPI | 1043795164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 24-QMHS-I-0008) |
| 172V00000X Community Health Worker | |
| 175T00000X Peer Specialist | |
| 175T00000X Peer Specialist (Licence: CA MPSS-LIADFM) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2024-09-15 |