| NPI | 1164793394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CO MI-4601) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: CO NA-365660) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |