NPI | 1013416908 |
---|---|
Former Name | ALYSSA MARIE LEBLANC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP14814) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 7846) |
Enumeration Date | 2018-02-06 |
Last Update Date | 2023-09-12 |