| NPI | 1215565825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 272922) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: IL 36787) |
| 175T00000X Peer Specialist (Licence: KY 1166980) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2022-06-23 |