| NPI | 1578760203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OK 100479240D) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OK 100479240B) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2007-07-08 |