| 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 |