| NPI | 1811621337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTB-2024-0224) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NM 1206) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2024-04-09 |