NPI | 1003561093 |
---|---|
Former Name | ASHLEY GWEN GARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S-5002) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL 19647) |
Enumeration Date | 2022-02-17 |
Last Update Date | 2023-01-05 |