| NPI | 1720499916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: TX 212628) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL 13484) |
| Enumeration Date | 2014-05-10 |
| Last Update Date | 2014-05-10 |