| NPI | 1043605710 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 115854) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.11974) | 
| Enumeration Date | 2015-03-31 | 
| Last Update Date | 2020-12-08 |