| NPI | 1093885030 |
|---|---|
| Former Name | BRENDA JEAN STUBBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MT PTP-PT-LIC-24539) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 02133) |
| 225100000X Physical Therapist (Licence: IA 1131PT) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2022-10-07 |