| NPI | 1063542959 |
|---|---|
| Former Name | STACY LYNN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 372500000X Chore Provider |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |