| NPI | 1265667851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: KS 1702306) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: NE 470) |
| 222Q00000X Developmental Therapist (Licence: MO 2005032056) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |