| NPI | 1508299785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 604739051) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 604738051) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |