| NPI | 1710075700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 611) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 2579) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-01-05 |