| NPI | 1407577968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P021851) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-30634) |
| 175T00000X Peer Specialist (Licence: NC 2022-9757-01) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2025-04-08 |