| NPI | 1457142507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: OH 9437817734VD) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-17 |