| NPI | 1356099634 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-DXUWOS) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2025-08-07 |