| NPI | 1508467200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ MT-14892) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LMSW-16886) |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2022-03-04 |