| NPI | 1669912200 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 174H00000X Health Educator | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2017-03-01 | 
| Last Update Date | 2017-03-02 |