| NPI | 1144642588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 812668141) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 812667141) |
| Enumeration Date | 2014-01-18 |
| Last Update Date | 2014-01-18 |