| NPI | 1972642338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO 6117-8985) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |