| NPI | 1619444304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 374700000X Technician | |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2024-06-25 |