| NPI | 1275175721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NY 3999) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2021-11-04 |