| NPI | 1093109092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: PA 3975912) |
| Additional Taxonomies | 235500000X Specialist/Technologist (Licence: PA 3975912) |
| 235Z00000X Speech-Language Pathologist, (Licence: PA 3975912) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |