| NPI | 1205222924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2022-03-28 |