NPI | 1093230146 |
---|---|
Former Name | BLAKE SCOLLICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101005800) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV 1803) |
Enumeration Date | 2017-08-10 |
Last Update Date | 2018-09-18 |