| NPI | 1700149770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT16778) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH15681) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2018-01-23 |