| NPI | 1891540225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |