| NPI | 1457002230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR THW000104665) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 21-10-10256) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-01-13 |