| NPI | 1508046228 |
|---|---|
| Former Name | CORALLEE ELIZABETH KOWALLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00024666) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: WA MA00024666) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2022-08-29 |