| NPI | 1851959977 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |