| NPI | 1326750423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ BH4047) |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2023-01-12 |