| NPI | 1003555657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |