| NPI | 1093060212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 219739081) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 265880081) |
| 252Y00000X Early Intervention Provider Agency (Licence: NY 443019101) | |
| 252Y00000X Early Intervention Provider Agency (Licence: NY 443018101) | |
| Enumeration Date | 2012-07-14 |
| Last Update Date | 2012-07-14 |