| NPI | 1770815813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA11093)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA35505)  | 
| Enumeration Date | 2010-01-30 | 
| Last Update Date | 2010-01-30 |