| NPI | 1346808805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |