| NPI | 1285014654 |
|---|---|
| Former Name | KAILIE ASAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2023-08-25 |