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Individual
SANI PAGE
Active
Individual
SANI PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RC
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/02/2025
Last updated
10/06/2025
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