| NPI | 1003576505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 222Q00000X Developmental Therapist | |
| 251C00000X | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2024-01-04 |