| NPI | 1740953454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2024-07-12 |