| NPI | 1386896918 |
|---|---|
| Former Name | BRENDA YVONNE HEINRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: MI 5501017621) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8178) |
| 225100000X Physical Therapist (Licence: CA 35368) | |
| 225100000X Physical Therapist (Licence: FL 24824) | |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2016-07-28 |