| NPI | 1538797493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-113907) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-08-29 |