NPI | 1063850618 |
---|---|
Former Name | KIMBERLY ELLEN HACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DE O1-0001374) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: DE 040000373) |
Enumeration Date | 2013-06-05 |
Last Update Date | 2015-04-16 |