| NPI | 1104661602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1099480) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: MN 1099480) |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: MN 1099480) | |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |