| NPI | 1952575086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62820) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2018-06-27 |