| NPI | 1710750062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WA CG61541361) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 61361890) |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-08-07 |