| NPI | 1083448559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: WV 364455) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-12-23 |