| NPI | 1063966471 |
|---|---|
| Former Name | MILISSA KATHERINE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AZ SLPA9938) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |