| NPI | 1679824213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 696020961) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 696021961) |
| 252Y00000X Early Intervention Provider Agency (Licence: NY 114093021) | |
| Enumeration Date | 2012-09-22 |
| Last Update Date | 2012-09-22 |