| NPI | 1205497732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR 19-CRM-021) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |