| NPI | 1003778820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 172A00000X Driver | |
| 174200000X Meals | |
| Enumeration Date | 2025-12-01 |
| Last Update Date | 2025-12-01 |