| NPI | 1730574369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 624079051) |
| Additional Taxonomies | 251B00000X Case Management (Licence: NY 624079051) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |