| NPI | 1225658065 |
|---|---|
| Former Name | MELANIE MANDABON NAZARENO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020026343) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040127) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2025-07-08 |