| NPI | 1962694794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L10647) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 13268) |
| 225700000X Massage Therapist (Licence: WA MA00011644) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2025-10-26 |