| NPI | 1942741251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 172A00000X Driver | |
| 225600000X Dance Therapist | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2020-09-03 |