NPI | 1073724449 |
---|---|
Former Name | TERESA C RUDKIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP10908) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NM 3371) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2020-04-21 |