| NPI | 1598078511 |
|---|---|
| Former Name | HALEY WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT25676) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1182629) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-07-19 |