| NPI | 1902357742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 373H00000X Day Training/Habilitation Specialist (Licence: TX 373h00000x) | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2017-01-04 |