| NPI | 1407515398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 372500000X Chore Provider |
| 172A00000X Driver | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2025-02-03 |