| NPI | 1073743571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 104921) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 21772) | 
| Enumeration Date | 2009-07-17 | 
| Last Update Date | 2022-08-29 |