| NPI | 1710241211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 428535101) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 001194) |
| 252Y00000X Early Intervention Provider Agency (Licence: NY 428536101) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2021-06-24 |