| NPI | 1639505894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 2130948) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2022-07-22 |