| NPI | 1407512452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: NY 5504) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 5366) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2023-11-13 |