| NPI | 1588290902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 17-crm-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 21-07-10191) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2021-07-15 |