| NPI | 1407722705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 1407722705) |
| Additional Taxonomies | 251B00000X Case Management (Licence: ID 1407722705) |
| 222Q00000X Developmental Therapist | |
| 261QD1600X Clinic/Center, Developmental Disabilities (Licence: ID 1407722705) | |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2026-05-29 |