| NPI | 1881350122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 22541) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306324) | |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2023-05-29 |