| NPI | 1487182044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: PR 976) | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI2943) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2017-11-28 |