| NPI | 1083012041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 4593-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101003859) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2022-10-11 |