| NPI | 1053673681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: FL 1053673681) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 469681041) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-07-10 |