NPI | 1083907984 |
---|---|
Former Name | TOSHA MARIE DUNLAP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: FL OTA10267) |
Enumeration Date | 2011-05-25 |
Last Update Date | 2011-05-25 |