| NPI | 1508295221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: DE J2-0000338) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: DE J2-0000338) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2015-11-03 |