| NPI | 1598133969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 694867122) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 973938152) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2015-09-02 |