| NPI | 1013280155 |
|---|---|
| Former Name | KRISTINA LEANNE LOUCKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA OTR 12475) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |