| NPI | 1245535723 |
|---|---|
| Former Name | DEBRA SHALEEN TATUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR PTA1444) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 1444) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2022-02-04 |