| NPI | 1669297586 |
|---|---|
| Former Name | JADE BRINK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 225600000X Dance Therapist |
| Enumeration Date | 2024-11-15 |
| Last Update Date | 2024-11-15 |