| NPI | 1124480322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI DP-AADC) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: MI M-00425) |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-12-15 |