| NPI | 1417977380 |
|---|---|
| Former Name | MYRA ELAINE SHAMLOO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-03-23 |