| NPI | 1467856922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 14-09-16U3) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 16-CRM-079) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2019-01-11 |