| NPI | 1790291383 |
|---|---|
| Former Name | CORTNEY RIESBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-03515) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2019021791) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2026-02-10 |