| NPI | 1366718843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: KY A5077) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: IN 99045801A) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |