| NPI | 1942637863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 1614374) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1614374) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 1614374) | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2013-10-09 |