| NPI | 1558030999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE MARIE WILKERSON HANSEN Intervention Professional 707-815-3858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |