| NPI | 1568716173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: PA 14066891) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: PA 14066891) |
| 235Z00000X Speech-Language Pathologist, (Licence: PA 14066891) | |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |