NPI | 1053564211 |
---|---|
Former Name | CAITLIN MARIE WYATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CT 004133) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 019003-1) |
Enumeration Date | 2008-10-30 |
Last Update Date | 2022-11-03 |