| NPI | 1609563006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 279087) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: KY 202232) |
| 175T00000X Peer Specialist (Licence: KY 279087) | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-19 |