| NPI | 1275999138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90973) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 1439) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2024-02-05 |