| NPI | 1477193449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 288208) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2024-05-06 |