| NPI | 1457826679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030693) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-53327) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2024-04-10 |