| NPI | 1649900085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 45-4913755) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 1962760678) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-06-16 |