| NPI | 1437037223 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: NM 1915) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTB-2026-0347) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2026-05-28 |