| NPI | 1255647632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 225100000X Physical Therapist (Licence: CA pt5864) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: CA pt5864) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |