| NPI | 1578520193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA19731) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-03-17 |