| NPI | 1457955866 |
|---|---|
| Former Name | CAROLYN ANN BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 376J00000X Homemaker |
| 3747P1801X Technician Personal Care Attendant | |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2022-11-22 |