NPI | 1093952574 |
---|---|
Former Name | BRENDA MARIE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101006669) |
235Z00000X Speech-Language Pathologist, (Licence: WA SI60030945) | |
Enumeration Date | 2009-01-20 |
Last Update Date | 2023-08-18 |