| NPI | 1063887891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: HI 751168273) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: HI 751168273) |
| 1223G0001X Dentist, General Practice (Licence: HI 751168273) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: HI 751168273) | |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |