| NPI | 1528576360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017348) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA 16-22148) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2024-12-10 |