| NPI | 1265272033 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P020622) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 15094) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-29 |