| NPI | 1265961809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 103K00000X Behavior Analyst | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2018-06-16 |