| NPI | 1457139107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-21-1197) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 23-CRM-2058) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |