| NPI | 1790214633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-21-806) | 
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 4395998) | 
| Enumeration Date | 2017-06-05 | 
| Last Update Date | 2024-09-18 |