| NPI | 1730365891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH E 0003905) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 009605) |
| 225100000X Physical Therapist (Licence: WI 4413 - 024) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2008-01-18 |