| NPI | 1376212241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA 172V00000X) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 1346528106) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-08-16 |