| NPI | 1003499021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008663) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.011850) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |