| NPI | 1003043456 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP8698) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 10482802) | 
| Enumeration Date | 2009-06-12 | 
| Last Update Date | 2009-06-12 |