NPI | 1023685161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 1435314201) |
Additional Taxonomies | 174400000X Specialist (Licence: 1435314201) |
Enumeration Date | 2021-06-08 |
Last Update Date | 2021-06-09 |