| NPI | 1508101908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: NC OT8720) |
| Additional Taxonomies | 171W00000X Contractor (Licence: FL OT9419) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2014-09-25 |