| NPI | 1205678729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor (Licence: IA 99398) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: AZ 41165) |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-07 |