| NPI | 1578341731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 110022)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 23-QMHA-R-4637)  | 
| Enumeration Date | 2023-09-19 | 
| Last Update Date | 2024-07-24 |