| NPI | 1760920466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1625) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2020-04-16 |