| NPI | 1710651930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-11-10 |