| NPI | 1043654601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL 00003362) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1141) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |