| NPI | 1578604070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PR 1113) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2023-03-24 |