| NPI | 1114411279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: VA 0735000071) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2021-01-15 |