| NPI | 1033602800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |