| NPI | 1194327999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: 54542) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: 73559) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |