| NPI | 1245653559 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT2682) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA75411) | 
| Enumeration Date | 2014-01-23 | 
| Last Update Date | 2023-04-20 |