| NPI | 1316687585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-07-22 |