| NPI | 1912560632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5156865) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |