| NPI | 1932743010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 22950) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2022-07-04 |