| NPI | 1043990781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3536) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 25-CEM-II-0499) |
| 101Y00000X Counselor (Licence: OR 26-QMHA-R-8085) | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2026-03-04 |