| NPI | 1174164040 |
|---|---|
| Former Name | KRISTEN CARMONA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2021-06-01 |