| NPI | 1699020511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 104100000X Social Worker |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2020-01-15 |