| NPI | 1205659927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 171W00000X Contractor |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-03 |