| NPI | 1073728614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 12041536) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 103282) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-06-12 |