| NPI | 1265075790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 19-CRM-250) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2025-04-03 |