| NPI | 1013247998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6109) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 14673) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2015-04-30 |