| NPI | 1104237205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 246Y00000X Spec/Tech, Health Info (Licence: IL 0465641) |
| 246Y00000X Spec/Tech, Health Info | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2015-08-24 |