| NPI | 1861192353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: MN 411159) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 411159) |
| 122300000X Dentist (Licence: MN 411159) | |
| 251J00000X Nursing Care (Licence: MN 411159) | |
| 253J00000X Foster Care Agency (Licence: MN 411159) | |
| 261Q00000X Clinic/Center (Licence: MN 411159) | |
| 261QR0800X Clinic/Center Recovery Care (Licence: MN 411159) | |
| 310400000X Assisted Living Facility (Licence: MN 411159) | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-03-06 |