| NPI | 1104227487 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2014-09-05 | 
| Last Update Date | 2019-07-11 |