| NPI | 1447921572 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 175T00000X Peer Specialist | |
| Enumeration Date | 2021-09-28 | 
| Last Update Date | 2021-09-28 |