| NPI | 1780948349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School |
| Additional Taxonomies | 174400000X Specialist |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-11-12 |