| NPI | 1902058092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 249629081) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 249628081) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |