| NPI | 1548635022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4997) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 715) |
| 225700000X Massage Therapist (Licence: WV 0076) | |
| 225700000X Massage Therapist (Licence: MD 01632) | |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |