| NPI | 1588441646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA 101Y00000X) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA 175T00000X) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-10-01 |