| NPI | 1316453186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-20-340) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 17-CRM-110) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2020-10-06 |