| NPI | 1053292508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1913143251) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |