| NPI | 1780148023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CDCA.169313) |
| Additional Taxonomies | 101Y00000X Counselor |
| 175T00000X Peer Specialist (Licence: KY APS.006014) | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2025-09-26 |