| NPI | 1750081345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: MA 0397) |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2025-10-22 |