| NPI | 1063073864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 13142) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 13142) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2021-11-22 |