| NPI | 1811412356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-05 |
| Last Update Date | 2017-08-11 |