| NPI | 1235842295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 282440) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: KY 282440) |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-01-04 |