| NPI | 1740420108 |
|---|---|
| Former Name | HEATHER THERESA ST. AMOUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1228650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01299700) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2023-08-29 |