| NPI | 1053631226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 6929) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL SA 6929) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2015-11-24 |