| NPI | 1902381338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2021-09-29 |