NPI | 1053582700 |
---|---|
Former Name | REBECCA LEE REXRODE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006873) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV 12049254) |
Enumeration Date | 2008-03-20 |
Last Update Date | 2024-09-06 |