| NPI | 1003902651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 002953) |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-04-13 |