| NPI | 1881940732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 344857091) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 325358091) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2012-07-30 |