| NPI | 1346768736 |
|---|---|
| Former Name | KRISTEN MICHELLE O'DONNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 082568) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 001187) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-07-21 |