| NPI | 1356913669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 18CRM066) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR T19458) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 18CRM066) | |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-07-15 |