NPI | 1053730770 |
---|---|
Former Name | KAILLIE MARIE ENSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 242.004721) |
Additional Taxonomies | 225A00000X Music Therapist |
Enumeration Date | 2014-04-09 |
Last Update Date | 2018-09-13 |