| NPI | 1518653617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: UT F24-114604) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2025-08-18 |