NPI | 1023603834 |
---|---|
Former Name | AUDREY GRACE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN 6201) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 0000006201) |
Enumeration Date | 2021-03-03 |
Last Update Date | 2024-09-05 |