| NPI | 1881180099 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 106S00000X Behavior Technician | |
| 253Z00000X In Home Supportive Care | |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2025-01-15 |