| NPI | 1174145502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 1731) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 553) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |