| NPI | 1124863097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 10425) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: VA 10425) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-08-05 |