| NPI | 1790152361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209797) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI CP052262T) |
| 225100000X Physical Therapist (Licence: FL PT32983) | |
| 225100000X Physical Therapist (Licence: NC CP052259T) | |
| 225100000X Physical Therapist (Licence: GA CP052257T) | |
| 225100000X Physical Therapist (Licence: TN CP052261T) | |
| 225100000X Physical Therapist (Licence: SC CP052260T) | |
| 225100000X Physical Therapist (Licence: KY CP052258T) | |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2026-01-28 |