| NPI | 1760109128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2024-07-25 |