| NPI | 1679020127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: NM 286262) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: TX 02734408) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |