| NPI | 1205441052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WY OL-21-41284) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WY CO260756) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |