| NPI | 1215239637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119004559) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306000902) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-12-08 |