| NPI | 1710309992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 174400000X Specialist |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2019-08-13 |