| NPI | 1972914968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 771583131) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 771583131) |
| 252Y00000X Early Intervention Provider Agency (Licence: NY 771732131) | |
| 174400000X Specialist (Licence: NY 771732131) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-20 |