| NPI | 1659121143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 41232-P) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NY 6380) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-09-24 |