| NPI | 1790310712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 347C00000X Private Vehicle | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2025-09-15 |