| NPI | 1356128359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-23-2791) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2025-01-02 |