| NPI | 1770951386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 30805) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL PT 30805) |
| 222Q00000X Developmental Therapist (Licence: FL PT 30805) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |