| NPI | 1235550427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 210385) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 210385) |
| Enumeration Date | 2013-12-15 |
| Last Update Date | 2016-12-08 |