| NPI | 1790236156 |
|---|---|
| Former Name | BARBARA ANN HIEDEMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: MA 12094) |
| Additional Taxonomies | 251S00000X (Licence: VT 072.0103363) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |