NPI | 1578760609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OK 100636900B) |
Additional Taxonomies | 347C00000X Private Vehicle (Licence: OK 110636900C) |
Enumeration Date | 2007-07-02 |
Last Update Date | 2007-07-08 |