| NPI | 1013328707 |
|---|---|
| Former Name | JESSICA JEANNE MIRT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 3792) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS k01754066) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-11-25 |