| NPI | 1518324847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 1001522151) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 955942151) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2016-01-18 |