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 |