| NPI | 1104047737 |
|---|---|
| Former Name | KAYTLEN ANNE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3058) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: ME PT3058) |
| 174400000X Specialist (Licence: ME 3058) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-01-06 |