| NPI | 1912276783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 174400000X Specialist |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2025-03-24 |