| NPI | 1245692227 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care (Licence: AZ BH5130) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 3747P1801X Technician, Personal Care Attendant (Licence: AZ LP048680) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2017-12-05 |