| NPI | 1801554795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: KY 1197269) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-08 |