| NPI | 1649801051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA CG61116473) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: WA CM60858135) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2021-04-22 |