| NPI | 1639959240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 286475) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2025-05-28 |