| NPI | 1225533003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-04-17 |