| NPI | 1083014948 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 15051812) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 904475141) | 
| 235Z00000X Speech-Language Pathologist, (Licence: NY 945776151) | |
| Enumeration Date | 2014-08-28 | 
| Last Update Date | 2021-03-02 |