| NPI | 1265051726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-20-168) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-12-08 |