| NPI | 1053877274 |
|---|---|
| Former Name | MELODY CRYSTAL HARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: VA 0119006879) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |