NPI | 1003168816 |
---|---|
Former Name | KIMBERLY ANNE DIMAYUGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 111855) |
Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
Enumeration Date | 2012-10-04 |
Last Update Date | 2022-07-07 |