| NPI | 1881006419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: KY 134651) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2020-09-14 |