| NPI | 1184146607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-21-915) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: 13-crm-020) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-09-21 |