NPI | 1013080514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005916) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 117884) |
Enumeration Date | 2006-11-15 |
Last Update Date | 2021-04-06 |