| NPI | 1831172477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305006303) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0704009537) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-05-15 |