NPI | 1730948241 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X (Licence: PA BH005163) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: PA BH005163) | |
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
Enumeration Date | 2024-03-18 |
Last Update Date | 2024-03-23 |