| NPI | 1316717861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: OR THW000109818) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 109818) |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2026-04-30 |