| NPI | 1184909350 |
|---|---|
| Former Name | PAIGE MARIE AUTUMN WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: OH 33.017440) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OH 33.017440) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2019-04-26 |