| NPI | 1588136303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA0006X Clinic/Center, Ambulatory Fertility Facility |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 261QA3000X Clinic/Center, Augmentative Communication | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2018-12-18 |