| NPI | 1205475241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral | |
| 103TE1100X Psychologist, Exercise & Sports | |
| Enumeration Date | 2019-12-21 |
| Last Update Date | 2019-12-21 |