NPI | 1013556661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2019047146) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 4300) |
Enumeration Date | 2019-12-31 |
Last Update Date | 2019-12-31 |