| NPI | 1063826550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 798187131) |
| 174400000X Specialist (Licence: NY 798319131) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2023-08-17 |