| NPI | 1770117764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG014942) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA 1-20-41153) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2024-09-11 |