| NPI | 1023356417 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: AL 3562)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: GA PCET001871)  | 
| 235Z00000X Speech-Language Pathologist,   (Licence: GA SLP008417)  | |
| Enumeration Date | 2013-01-21 | 
| Last Update Date | 2016-03-01 |