| NPI | 1013293448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006459) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 4281) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2018-08-08 |