| NPI | 1245109743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: ID 13056) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171400000X Health & Wellness Coach (Licence: ID 13056) | |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2026-07-22 |