| NPI | 1053821736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA CG61009839) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR PHW2019) |
| 175T00000X Peer Specialist (Licence: OR THW2019) | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2019-11-18 |