| NPI | 1902580269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: KY 1208767) |
| 175T00000X Peer Specialist (Licence: KY 1208767) | |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-10-09 |