| NPI | 1164933396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 171W00000X Contractor |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2017-10-16 |