| NPI | 1679967699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL 234691) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: FL 1000063476) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2017-08-03 |