| NPI | 1740963594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 40061) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 38689-T) |
| 175T00000X Peer Specialist (Licence: NY 4894) | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2025-02-05 |