| NPI | 1700961877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT9391) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-01-14 |