| NPI | 1811656713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 13754) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: MT 50096) |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-08 |