| NPI | 1043710163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-2019) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KY 252192) |
| 235Z00000X Speech-Language Pathologist, (Licence: VA 2202002853) | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2019-10-11 |