| NPI | 1699945253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: TX 112546) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 112546) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2014-02-28 |