| NPI | 1164079570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: NM 841) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NA) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2020-09-03 |