| NPI | 1306417183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501304076) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2025-08-28 |