| NPI | 1033630868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2023-03-21 |