| NPI | 1407525512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA DUFAYHMVWRXBJTGQ) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1408741020) |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2023-01-09 |