| NPI | 1457859563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA79787) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2020-07-24 |