| NPI | 1598265803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 376J00000X Homemaker | |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2022-03-28 |