| NPI | 1124174784 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: MA 3232)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6108)  | 
| Enumeration Date | 2007-01-26 | 
| Last Update Date | 2025-09-11 |