| NPI | 1962923474 |
|---|---|
| Former Name | VERNICE DOLORES GALLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: NC 1702) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: NC 19360) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2021-03-15 |