NPI | 1598511404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 24-CRM-3165) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-4088) |
Enumeration Date | 2024-04-30 |
Last Update Date | 2025-01-10 |