| NPI | 1063390870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 105324) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: OR 25-QMHA-R-6774) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-25-5762) | |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-10-03 |