| NPI | 1043871577 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP11849) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP11849) | 
| Enumeration Date | 2019-06-25 | 
| Last Update Date | 2022-05-20 |