| NPI | 1609297035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 167981) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: KY 0771) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2021-11-02 |