| NPI | 1871305524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |