NPI | 1073862025 |
---|---|
Former Name | EMILY MOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP7889) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP7889) |
Enumeration Date | 2012-09-06 |
Last Update Date | 2015-03-16 |