NPI | 1013388503 |
---|---|
Former Name | AMANDA LYNN RANOCCHIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 12130032) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007510) |
Enumeration Date | 2015-10-09 |
Last Update Date | 2015-10-09 |