| NPI | 1508429382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 172A00000X Driver (Licence: OR 8851050) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |