NPI | 1629426622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4785) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-05-30) |
175T00000X Peer Specialist (Licence: OR 107250) | |
Enumeration Date | 2016-05-31 |
Last Update Date | 2022-09-13 |