| NPI | 1689732893 |
|---|---|
| Former Name | YOLANDA WILLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 9217) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: NC 9217) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2019-07-12 |