| NPI | 1407390966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR THW1523) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2020-01-21 |