| NPI | 1689036576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO MT.0023205) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002650) |
| 225700000X Massage Therapist (Licence: GA MT010471) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-01-24 |