| NPI | 1649600248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 24114) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2018-07-19 |