| NPI | 1205856721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 17093) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P1 60570192) |
| 225200000X Physical Therapy Assistant (Licence: ID PTA-4190) | |
| 225200000X Physical Therapy Assistant (Licence: OR 8372) | |
| 225700000X Massage Therapist (Licence: WA MA 60625900) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-01-05 |