| NPI | 1174538557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT16501) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL 16501) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2025-10-17 |