| NPI | 1962922716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH21230) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2024-04-09 |