| NPI | 1184155178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: TX 54906) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX 120766) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |