| NPI | 1780030577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 251C00000X | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |