| NPI | 1053746073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 110076) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 109197) | 
| Enumeration Date | 2013-09-10 | 
| Last Update Date | 2014-07-07 |