| NPI | 1699461848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 101Y00000X Counselor |
| 225800000X Recreation Therapist | |
| 251S00000X | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-13 |