| NPI | 1467608083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OR sm1219) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OR sm1219) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2010-07-29 |