| NPI | 1003370594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 2838720) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 2838720) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |