| NPI | 1366229122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1112024) |
| Additional Taxonomies | 253J00000X Foster Care Agency (Licence: MN 1114922) |
| 253Z00000X In Home Supportive Care (Licence: MN 1112024) | |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |