| NPI | 1952451874 |
|---|---|
| Former Name | KATHLEEN HICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT30755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 004445) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CT 000201) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2015-12-31 |