| NPI | 1154002830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WY CAP-205) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2025-07-10 |