| NPI | 1659824613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: KY 201112352) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2020-05-08 |