| NPI | 1700041480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32625) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT32625) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 08351-1) | |
| 252Y00000X Early Intervention Provider Agency (Licence: FL PT32625) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2018-10-02 |