| NPI | 1992364566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 19-CGRM-001) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 19-03-08) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2019-06-07 |