| NPI | 1366937690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: TX 714040) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |