| NPI | 1295153625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 2609247) |
| Additional Taxonomies | 251S00000X (Licence: NY 002213) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-05-08 |