| NPI | 1982318895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA CIT-6007) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: LA OBHPSS896) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2025-10-08 |