| NPI | 1750559647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC PTA80235374) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: WV PTA 001124) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2022-07-21 |