| NPI | 1669915260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MI 7501011871) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2025-03-27 |