| NPI | 1720463086 |
|---|---|
| Former Name | CECILIA GRACE FASANELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 116910) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID 1470) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2019-01-28 |