| NPI | 1104043397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC006264) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017347) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2018-07-12 |