| NPI | 1073722658 |
|---|---|
| Former Name | DANIELLE MARIE MULLENBACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CA AT 8388) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ME PA2885) |
| 225200000X Physical Therapy Assistant (Licence: IA 00938) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-01-13 |