| NPI | 1609376714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253J00000X Foster Care Agency (Licence: AZ 7649399) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP030081) |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child (Licence: AZ 7649399) | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2020-03-19 |