| NPI | 1124645833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-07-23 |