| NPI | 1114145331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 2162102) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NONE) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-07-14 |