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 |