| NPI | 1003212614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: VA 2202007639) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: MD 07719) |
| 235Z00000X Speech-Language Pathologist (Licence: OH SP.09951) | |
| 235Z00000X Speech-Language Pathologist (Licence: AZ SLP10213) | |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2018-04-20 |