NPI | 1033408463 |
---|---|
Former Name | SARA DARLENE KIETZMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11769) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ5353) |
Enumeration Date | 2011-04-06 |
Last Update Date | 2022-10-11 |