| NPI | 1386973170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A15439) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3543) |
| 225700000X Massage Therapist (Licence: FL MA70168) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2020-02-03 |