| NPI | 1679623961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: TX 27867) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 106456) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |