| NPI | 1124480322 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: MI M-00425)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2016-03-25 | 
| Last Update Date | 2025-06-04 |