| NPI | 1447886551 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: TX L-136295) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT115676) | 
| Enumeration Date | 2020-03-20 | 
| Last Update Date | 2020-03-20 |