| NPI | 1619357647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: FL PT30360) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT30360) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL 30360) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2022-11-28 |