| NPI | 1053785139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101006085) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 242.003798) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2019-08-30 |