| NPI | 1265960934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 090710-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 090710-1) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-05-25 |