| NPI | 1699282160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-19-405) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR THW2412) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2019-08-28 |