| NPI | 1720832066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 347C00000X Private Vehicle | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2025-01-20 |