| NPI | 1407545882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: VA 6503) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: VA 6503) |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-05-03 |