| NPI | 1558705384 |
|---|---|
| Former Name | TINA JEAN BURNHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MN MT3400292) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0021382) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2024-03-26 |