| NPI | 1649784067 |
|---|---|
| Former Name | KATRINA CAREEN MIRACLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 175T00000X Peer Specialist (Licence: OR 17-CRM-184) | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2022-12-22 |