| NPI | 1942459755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC012297) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE000814L) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2020-10-09 |