| NPI | 1093463879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 22-CRM-919) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: T-22-1507) |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-04-22 |