| NPI | 1013109404 |
|---|---|
| Former Name | CARISSA BOEHMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 143469) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 7074) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2022-07-21 |