| NPI | 1851779755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2024-11-17 |