| NPI | 1073915906 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 15990) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, | 
| Enumeration Date | 2014-09-23 | 
| Last Update Date | 2017-04-19 |