| NPI | 1336951938 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: OR 3439) | 
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 3439) | 
| Enumeration Date | 2025-01-22 | 
| Last Update Date | 2025-01-22 |