| NPI | 1063120160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-07-05) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 18-CRM-II-001) |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-11-08 |