| NPI | 1316295553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |