| NPI | 1689129124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: 49039) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: 4220542) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |