| NPI | 1063001030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |