| NPI | 1245766187 |
|---|---|
| Other Name | KYMBURR MATA ROARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |