| NPI | 1083242697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: KY 1177625) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 279993) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-04-25 |