| NPI | 1689629420 |
|---|---|
| Former Name | MICHELLE KOENIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 25343) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06993) |
| 225X00000X Occupational Therapist (Licence: LA 200099) | |
| 225X00000X Occupational Therapist (Licence: FL 14636) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2015-03-30 |