| NPI | 1891395430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL L20000294693) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2023-02-09 |