| NPI | 1154771988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 9315) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-05-29 |