| NPI | 1518047349 |
|---|---|
| Former Name | THERESA PAYNTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 81099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 12659) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2018-01-14 |