| NPI | 1083193825 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist | 
| Additional Taxonomies | 225X00000X Occupational Therapist | 
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2018-08-13 | 
| Last Update Date | 2018-08-13 |