| NPI | 1952170540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 1742362231) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 1742367231) |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2023-12-25 |