| NPI | 1053923565 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101007441) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NC 14273) | 
| Enumeration Date | 2020-08-18 | 
| Last Update Date | 2023-03-14 |