| NPI | 1144776105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 026924) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 2680067) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2017-08-09 |