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 |