| NPI | 1861975195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 171W00000X Contractor |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2022-02-03 |