| NPI | 1710337555 |
|---|---|
| Former Name | MALINDA MARIE CHILDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: WA PT60639116) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3572) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2019-06-05 |