An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Developmental Disabilities | 261QD1600X |
* Indicates primary specialty
| NPI Number | 1295030666 |
| Credentials | PH.D. CPCRT |
| Entity | Individual |
| Enumeration date | 01/17/2011 |
| Last updated | 01/17/2011 - About 15 years ago |
| Sole proprietor1 | Yes |
| Identifiers | n/a |
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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