| NPI | 1831604123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 247200000X Technician, Other |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2018-04-18 |