| NPI | 1093467193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI SA0823347) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2023-02-22 |