| NPI | 1639569833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 222Q00000X Developmental Therapist | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2015-01-27 | 
| Last Update Date | 2015-05-11 |