| NPI | 1518420603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1518420603) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2022-10-31 |