| NPI | 1962757815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 741399131) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NH 92781) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2014-04-07 |