| NPI | 1619720604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1625300725) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA mpss-jypnei) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2025-08-27 |