| NPI | 1598428146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 21-crm-321) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 261Q00000X Clinic/Center (Licence: OR 21-crm-321) | |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |