| NPI | 1770113094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: TX 120551) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: TX 120551) |
| 225XF0002X Occupational Therapist Feeding, Eating & Swallowing (Licence: TX 120551) | |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-01-26 |