| NPI | 1659249118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 45678) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: IL 38387) |
| 175T00000X Peer Specialist (Licence: KY 1214770) | |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2026-08-17 |