NPI | 1467152413 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 22-CRM--1462) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-23-2885) |
Enumeration Date | 2023-03-08 |
Last Update Date | 2024-07-17 |