| NPI | 1134247349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 070.012587) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2025-10-11 |