| NPI | 1467406785 |
|---|---|
| Former Name | GRACE KATHRYN WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA OT 8212) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT 8212) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-09-11 |