| NPI | 1063985406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134373) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2022-02-14 |