| NPI | 1417078973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 3360) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-07-09 |