| 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 |