| NPI | 1114536760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 101Y00000X Counselor | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2022-01-24 |