NPI | 1518965730 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN P2740) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT764) |
Enumeration Date | 2005-07-12 |
Last Update Date | 2019-01-18 |