| NPI | 1912600495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19634-130) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2023-11-18 |