NPI | 1700419959 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
106S00000X Behavior Technician | |
172V00000X Community Health Worker | |
Enumeration Date | 2020-02-17 |
Last Update Date | 2024-07-24 |