| NPI | 1043991284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 1183-prov) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: SD 1183-PROV) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-03-11 |