| NPI | 1801464300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: NC 1659513786) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NC 1659513786) |
| 175T00000X Peer Specialist (Licence: VA 2239) | |
| 251S00000X (Licence: VA 3399) | |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2024-02-08 |