| NPI | 1124768593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR THW000108865) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health (Licence: OR THW000108865) | |
| Enumeration Date | 2022-03-31 | 
| Last Update Date | 2024-11-13 |