| NPI | 1548739378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: FL 1548739378) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2019-03-01 |