NPI | 1588911754 |
---|---|
Former Name | THERESA MARY ANN ROY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225800000X Recreation Therapist (Licence: CA 41502) |
Additional Taxonomies | 174400000X Specialist (Licence: CA 41502) |
171W00000X Contractor (Licence: CA 41502) | |
Enumeration Date | 2012-08-07 |
Last Update Date | 2015-05-01 |