| NPI | 1972768976 |
|---|---|
| Former Name | SANDRA LEE MENTZER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12408) |
| Additional Taxonomies | 104100000X Social Worker |
| 222Q00000X Developmental Therapist | |
| 225100000X Physical Therapist (Licence: FL 31207) | |
| Enumeration Date | 2008-07-20 |
| Last Update Date | 2024-07-30 |