| NPI | 1235259292 |
|---|---|
| Former Name | MARY SHELLAH ELIZABETH MALANYAON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 33870) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 5252) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-10-19 |