| NPI | 1962960534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2019-03-03 |
| Last Update Date | 2023-05-25 |