| NPI | 1558936286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: LA 230780) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2022-12-13 |