| NPI | 1992248199 |
|---|---|
| Former Name | NICOLE EARLENE BOOHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 5648) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025416) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2026-01-09 |