| NPI | 1457195281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2025-07-30 |