| NPI | 1649686122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101Y00000X Counselor |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |