| NPI | 1174287684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 222Q00000X Developmental Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2021-10-30 |
| Last Update Date | 2024-08-14 |