| NPI | 1770173510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: PA 12935) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2022-05-03 |