| NPI | 1356749758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 847327141) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: NY 847327141) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |