| NPI | 1740560655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2304948) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA. 08140) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2023-08-14 |