| NPI | 1871303057 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 113055) | 
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR 113055) | 
| Enumeration Date | 2025-01-10 | 
| Last Update Date | 2025-06-20 |