| NPI | 1568980456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOKO BURRUSS Developmental Therapist 872-333-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: IL KB21490817P) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2018-06-16 |