NPI | 1053823799 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: 932490151) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 932490151) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2017-11-03 |