NPI | 1952038309 |
---|---|
Former Name | KRISTEN CORREIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1362069) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2022030821) |
Enumeration Date | 2022-08-05 |
Last Update Date | 2025-09-04 |