NPI | 1053732131 |
---|---|
Former Name | AMANDA PAIGE PARKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NM SLP5815) |
Additional Taxonomies | 2355S0801X Specialist/Technologist Speech-Language Assistant (Licence: NM 4765) |
Enumeration Date | 2013-12-17 |
Last Update Date | 2024-07-26 |