| NPI | 1114763422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: NM 1750) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NM 07262024) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTB-2026-0011) | |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2026-06-08 |