| NPI | 1548957699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: KY 201174935) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-08-07 |