| NPI | 1902521081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: WV E664036) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 22842) |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2025-03-02 |