NPI | 1164605168 |
---|---|
Former Name | LAUREN MARIE WHITEHOUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: UT 8142501-2401) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1168746) |
2251S0007X Physical Therapist, Sports (Licence: TX 1168746) | |
Enumeration Date | 2007-12-12 |
Last Update Date | 2012-01-30 |