NPI | 1003320961 |
---|---|
Former Name | SHANNA RENEE BODNAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL013370) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.11533) |
Enumeration Date | 2017-11-29 |
Last Update Date | 2017-11-29 |