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 |